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Acamprosate side effects: what 322 FDA adverse event reports show

Acamprosate Calcium · 8 reaction terms · 54 drug–reaction co-reports · data 2026-09-14
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Drug class

Not stated in label

Label matched

Acamprosate Calcium (Acamprosate Calcium)

closest FDA label found for this product string; brand list suppressed because the label is a related product, not an exact match

Who reports

322 reports · 84% serious · 37 with death outcome · 42% female

openFDA FAERS counts, all years, deduplication not applied

Used for

Acamprosate calcium is indicated for the maintenance of abstinence from alcohol in patients with alcohol dependence who are abstinent at treatment initiation. Treatment with acamprosate calcium should be part of a comprehensive management program that includes psychosocial support.

FDA label, Indications and Usage

What it is

Acamprosate calcium is supplied in an enteric-coated tablet for oral administration. Acamprosate calcium is a synthetic compound with a chemical structure similar to that of the endogenous ami.

FDA label, Description section

Boxed warning

None in the current label

How to read this page. FAERS is a spontaneous-reporting system: counts are not incidence rates and a signal is not proof of causation. Each reaction below is run through an automated screen — is the term in the FDA label (known), in the indications (the disease being treated), an administrative/coding term, or none of these (unlabeled)? That screen is mechanical text matching, not a causality assessment. The 30 hand-written Bradford Hill assessments are on the causality assessment page. Not medical advice.

Causality screen of the 6 strongest signals

Labeled (related wording) 1Reporting / coding artifact 1Not in label — unassessed 4
What the badges mean

Strongest disproportionality signals

Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only and flags pairs whose reports are unusually skewed by sex or come mostly from consumers rather than clinicians. 2 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.

Show:
ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Hepatic encephalopathy1069.8
37.9–128.5ROR 72.0 · χ² 611 / p 4e-135
61.9 EB05 35.9 · IC025 +3.0
3/3 methods agree
Not in label — unassessedserious PRR 47.7no trial data cached
Hepatic cytolysis948.0
25.2–91.4ROR 49.3 · χ² 368 / p 2e-82
43.8 EB05 24.7 · IC025 +2.6
3/3 methods agree
Not in label — unassessedserious PRR 29.1no trial data cached
Schizophrenia526.8
11.2–63.9ROR 27.2 · χ² 100 / p 9e-24
22.7 EB05 7.7 · IC025 +1.4
3/3 methods agree
Not in label — unassessedserious PRR 18.9no trial data cached
Cholestasis (bile flow blockage)620.5
9.3–45.2ROR 20.8 · χ² 93 / p 3e-22
17.4 EB05 6.4 · IC025 +1.6
3/3 methods agree
Not in label — unassessedserious PRR 14.1no trial data cached
Drug abuse97.0
3.7–13.3ROR 7.2 · χ² 41 / p 9e-11
5.4 EB05 3.0 · IC025 +1.3
3/3 methods agree
Reporting / coding artifactserious PRR 4.8no trial data cached

Trial evidence (ClinicalTrials.gov)

Trial cross-check not yet run for this drug (ClinicalTrials.gov pull covers the 800 most-reported drugs first).

Most frequently reported reactions

By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.

ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Hepatic encephalopathy1069.8
37.9–128.5ROR 72.0 · χ² 611 / p 4e-135
61.9 EB05 35.9 · IC025 +3.0
3/3 methods agree
Not in label — unassessedserious PRR 47.7no trial data cached
Drug abuse97.0
3.7–13.3ROR 7.2 · χ² 41 / p 9e-11
5.4 EB05 3.0 · IC025 +1.3
3/3 methods agree
Reporting / coding artifactserious PRR 4.8no trial data cached
Hepatic cytolysis948.0
25.2–91.4ROR 49.3 · χ² 368 / p 2e-82
43.8 EB05 24.7 · IC025 +2.6
3/3 methods agree
Not in label — unassessedserious PRR 29.1no trial data cached
Cholestasis (bile flow blockage)620.5
9.3–45.2ROR 20.8 · χ² 93 / p 3e-22
17.4 EB05 6.4 · IC025 +1.6
3/3 methods agree
Not in label — unassessedserious PRR 14.1no trial data cached
Schizophrenia526.8
11.2–63.9ROR 27.2 · χ² 100 / p 9e-24
22.7 EB05 7.7 · IC025 +1.4
3/3 methods agree
Not in label — unassessedserious PRR 18.9no trial data cached
Delusion416.8
6.4–44.6ROR 17.0 · χ² 45 / p 1e-11
10.9 EB05 3.2 · IC025 +0.8
3/3 methods agree
Not in label — unassessedserious PRR 13.8no trial data cached
Abortion induced427.6
10.4–73.2ROR 28.0 · χ² 78 / p 6e-19
21.4 EB05 5.6 · IC025 +1.0
3/3 methods agree
Not in label — unassessedserious PRR 19.7no trial data cached

Unlabeled candidate signals

Every screened signal with n ≥ 20 was either labeled, an indication term, or an artifact pattern — no unlabeled candidate stood out in the top signals.

Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.

Common questions

What are the most reported side effects of Acamprosate?

In FDA FAERS, the most frequently co-reported reaction terms for Acamprosate are hepatic encephalopathy, hepatic cytolysis, drug reaction with eosinophilia and systemic symptoms, cholestasis, schizophrenia, delusion. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.

Does Acamprosate have an FDA boxed warning?

No. The FDA label retrieved for Acamprosate has no boxed warning; see the label's Warnings and Precautions for the recognised risks.

Do FAERS signals prove that Acamprosate causes these side effects?

No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.

Sources & methods

Page generated 2026-10-08. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.